The Question of Rest for Women

The Question of Rest for Women During Menstruation is an extended version of an essay that won Dr. Jacobi the Harvard Medical School’s esteemed Boylston Prize in 1876. It was a significant event, as Jacobi was the first woman ever to win the competition. Beyond that, however, the book gives us a window onto two important nineteenth-century developments: the women’s rights crusades, and the growing importance of science in medicine.

This book marks the 10,000th the National Library of Medicine has uploaded its to online collections in Internet Archive as a part of its participation as a contributing partner to the Medical Heritage Library.

In 1876, Dr. Mary Putnam Jacobi was becoming a well-known and highly respected woman physician, which wasn’t a trivial accomplishment in that era. The eldest daughter of publisher George Palmer Putnam, she had been since childhood intensely rational and interested in science. She had obtained a degree from the New York College of Pharmacy in 1863, and her MD from the Woman’s Medical College of Pennsylvania in 1864. Dissatisfied with the level of her medical knowledge, she went to Paris in 1866, hoping to be admitted to the École de Médicine at the Sorbonne. After two years of attending clinics, lectures, and labs, she convinced the faculty to formally admit her as its first female degree candidate. She passed her exams with high honors and got a medal for her graduating thesis in 1871. Returning to New York, she established a private practice, joined the faculty of the Woman’s Medical College of the New York Infirmary, and, in 1873, married Dr. Abraham Jacobi, who is known as the father of American pediatrics.

The same year, Dr. Edward Clarke, recently retired from the Harvard Medical School faculty, published Sex in Education, or, A Fair Chance for the Girls, in which he earnestly explained the physiological reasons why girls should not be educated in the same way as boys. In general, he said, overworking the brain with long hours of study diverted the body’s energies from maintenance and growth. In both sexes, too much schoolwork could result in “monstrous brains and puny bodies; abnormally active cerebration and abnormally weak digestion; flowing thought and constipated bowels.” But girls, owing to their more complex and demanding reproductive “organization,” were at special risk. Especially during the teenage years, when their reproductive systems were maturing, they needed to respect the needs of their bodies and rest during menstrual periods. Clarke illustrated with seven case studies the dreadful consequences of neglecting this physiological reality.

Clarke’s arguments, while congenial to those who believed that women were not suited for work outside the “female sphere,” outraged women’s rights advocates. Among their responses was a hefty volume of essays published in 1874, The Education of American Girls, which included Jacobi’s “Mental Action and Physical Health.” In this, her first published defense of her theories of female physiology and women’s educational rights, Jacobi picked apart Clarke’s arguments, attacking his reasoning about disease causation, his knowledge of physiology, and his lack of experimental evidence. When the Harvard Medical faculty announced that the 1876 Boylston competition would be on the topic of the effects of menstruation on women, several leaders of the feminist community asked Jacobi to submit an essay.

Sex in Education, or, A Fair Chance for the Girls, by Dr. Edward Clarke, 1873

The Question of Rest for Women During Menstruation, by Dr. Mary Putnam Jacobi, 1877

Jacobi’s Boylston essay described her research into the questions of how women experienced menstruation, whether it disabled them to any extent, and whether there was any deterioration of health in those who didn’t rest. She discussed the current physiological literature on the subject; she surveyed 268 women and did experimental observations on smaller cohorts, including charting pulse pressure variations during menses, and presented a sophisticated statistical analysis of her data. And she concluded that there was “nothing in the nature of menstruation to imply the necessity, or even the desirability, of rest for women whose nutrition is really normal.”

A sphygmograph, similar to the instrument used by Dr. Mary Putnam Jacobi in her research. Courtesy M. Donald Blaufox, M.D., Ph.D

Measurements of the strength of the pulse by a sphygmograph, published by Dr. Mary Putnam Jacobi as part of her research into “The Question of Rest for Women During Menstration.”

Even among a generation of courageous, pioneering women physicians, Mary Putman Jacobi stands out. As historian Carla Bittel has noted in her 2009 book Mary Putnam Jacobi and the Politics of Medicine in Nineteenth-Century America:

“Jacobi drew clear boundaries around scientific medicine by demonstrating her own expertise. As some critics claimed women were incapable of scientific work, she turned the tables in the debate, displaying her own abilities and publicly holding men to higher standards. She tried to show that a woman could be a medical expert based not on her maternalism or her physical experience as a woman but on her mastery of physiology and chemistry. In the midst of gender conflicts, she overtly and intentionally exhibited her knowledge and skills while vocally denouncing what she saw as mediocre medical work.”

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Susan Speaker, PhD, is Historian for the Digital Manuscripts Program of the History of Medicine Division at the National Library of Medicine.